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Pulross Intermediate Care Centre

This service was previously managed by a different provider - see old profile

All reports

Inspection report

Date of Inspection: 6 July 2011
Date of Publication: 24 August 2011
Inspection Report published 24 August 2011 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

Our judgement

The care and welfare needs of people using this service have been taken into account in the way that their care is planned and delivered. Specialist advice was available and action has been taken to monitor and address people's health care needs.

Overall, we found that the Pulross centre was meeting this essential standard.

User experience

We saw that we saw that information for staff included advising the night-time staff of maintaining low noise levels throughout the night. There were 13 patients and we were told that 11 people needed physical help to mobilise and two also needed a high level of psychological support. We heard of the work underway to increase the patient empathy of the care assistants. Role play had been used by nurses to model how it feels to be a patient when staff stand over you when talking rather than sitting or bending to your level. There had also been discussion about staff needing to be mindful of their tone of voice and body language and how this could be misinterpreted by patients, who may already be feeling vulnerable. Staff told us that they were mindful of the corridor lights and how these affected people sleeping if they were not dimmed.

We met with one older person who likes to retire to bed late after watching television. They were receiving frequent encouragement to drink more fluid. A fluid intake chart was in place and was being kept up to date. It indicated a low fluid intake. We saw that drinks and soft fruit were available within this person's easy reach on a chair side table. The nurse told us of the diversion tactics of encouraging conversation that were being used to encourage older people to take sips of drinks. An emergency call bell was within the person's reach on the table also. The patient told us that they thought the staff were wonderful. They told us “The staff are ever so caring-it’s a great place to be whilst I can’t be at home. They tell me I am not eating and drinking enough”. We saw that there was clear information about the person's mobility needs and the mobility aid required, a walking frame, was positioned close by their armchair. The person told us that they found that the location of the en suite toilet convenient and that they were able to get there independently with the walking frame.

Other evidence

The provider told us that they have assured themselves to be fully compliant with this essential outcome area and they provided us with information about the systems they have in place for clinical governance and governance structures that cover arrangements for safety, clinical effectiveness, clinical guidance, quality improvement and clinical audit.

Pulross Intermediate Care Centre is a nurse led, 20 bed unit, which provides 24 hour nursing care and/or regular therapy intervention for people who are 18 years or over with chronic and/or specialist needs that cannot be met at home. The ward caters for people who require rehabilitation or have other care needs which cannot be met elsewhere. The inpatients are medically managed by GPs and care is enhanced by an elderly care consultant who provides specialist intervention to the unit once a week.

Inpatient assessment documents are designed to capture and reflect the wide range of people's individual needs. Assessment and care planning look at a wide range social, physical, mental and health needs. Particular areas of risk such as falls, risk of developing pressure sores, nutrition and safeguarding are assessed. Any risks and their associated risk management plans are recorded. A range of diagnostic tests and assessments can be completed at the centre and other diagnostic tests take place in the acute hospitals where people are sent to out patient clinics. There was training and guidance available for staff using medical devices.

Pulross had multidisciplinary inputs in place to provide a comprehensive assessment and ongoing rehabilitation and support. Each person's patient record contains key information about their physical, emotional, mental and social needs. Details of family and social situations are also recorded. The care plans show where care has been reviewed when care needs change. Pulross has close links with other teams and care providers such as therapies, social services, GPs and the local acute hospitals, including input from consultant geriatricians. There are case conferences to bring together professional carers and patients as well as joint documentation.

Patients can also be referred to an integrated enablement service for six weeks intensive health and social care support. The service will work with the patient to help them regain/maximise their independence in areas including washing and dressing, meal preparation, toileting, domestic tasks, improving mobility, transfers and managing stairs and outdoor mobility where appropriate, prior to a care package being determined. If other needs are identified, staff at Pulross will make a referral, for example, to district nursing services, community mental health teams, community psychologists, foot health, tissue viability, continence services, community matrons, heart failure team and the multiple sclerosis team.

The on call rota ensures that there is always a senior nurse available to the staff and advice is readily available from a senior clinician. Systems are in place to enable trust wide learning from incidents, accidents and complaints. Responses to patient safety alerts are monitored centrally through a risk team.